December 4, 2012

Empathetic Doctors Increase Pain Tolerance Of Their Patients

Researchers from Michigan State University (MSU) recently revealed that doctors who have empathy could help increase their patients´ pain tolerance.

In particular, the findings of the study looked at how the brain changes to respond to stress and found that certain shifts in the brain result in elevated pain tolerance. The medical researchers discovered that doctors who listened attentively to their patients could help them have better health outcomes. However, the team of investigators is not entirely sure about the mechanism that causes this reaction.

“This is the first study that has looked at the patient-centered relationship from a neurobiological point of view,” explained the study´s lead researcher Issidoros Sarinopoulos, a professor of radiology at MSU. “It´s important for doctors and others who advocate this type of relationship with the patient to show that there is a biological basis.”

In the project, the scientists randomly assigned patients to undergo one of two types of interviews prior to having an MRI scan done. For participants involved in the patient-centered approach, doctors discussed any concerns the patients had regarding the procedure and provided open-ended questions to allow the patients to speak about their home life, employment and other psychological or social factors that they thought impacted their health. The other set of patients were directed to answer only specific questions on their clinical background, such as their medical history or their drug regimen.

Based on a post-interview questionnaire, the participants who underwent the patient-focused interview showed greater satisfaction and confidence with their doctor.

The patients where also placed in an MRI scanner, where they were given a few mild electric shocks that gave them pain similar to the discomfort felt with the insertion of IV needles. They completed this exercise while looking at images of the two doctors who had managed the two different procedures. The scanner recorded the activity of the anterior insula — a part of the brain that makes you aware of pain — both before and during the electric shocks. The scientists then compared the results of the MRI scans.

They discovered that participants who had the patient-centered approach had less activity in the anterior insular than participants who underwent the approach that focused strictly on their clinical background. The participants of the pain-centered approach also self-reported less pain than the other group of participants.

The project was part of an overall effort to look at patient-centered health care and effective standards.

“Medicine has for too long focused just on the physical dimensions of the patient,” remarked the study´s co-author Dr. Robert Smith, a professor of medicine at MSU, in the statement. “Those clinical questions are important and necessary, but we´re trying to demonstrate that when you let patients tell their story in an unfettered way, you get more satisfied patients who end up healthier.”

Based on the findings of the study, the researchers believe that the project needs to be conducted again on a larger scale.

“We need to do more research to understand this mechanism,” noted Sarinopoulos in the statement. “But this is a good first step that puts some scientific weight behind the case for empathizing with patients, getting to know them and building trust.”